Background: Community development as an idea and practice for building health and wellbeing has been around a very long time and is a heavily researched area. Despite this there remains a lack of consensus about how it works best. A vast pool of theory suggests what should work, but little consensus exists of exactly how it works and for whom it works best in specific contexts.

The aims of this research are to utilise realist lenses to unpack the black box of what works in community health development, for whom it works and in which specific circumstances to improve health and wellbeing. A methods combination of realist synthesis and realist evaluation methods were employed and flexibility with the application of methods became crucial.

The Coronavirus Pandemic cut across the research at an early stage and made this work and findings even more poignant. The impact upon communities was universal. All communities were affected, but with variable consequences, as some communities were enabled to find new ways of operating and building wellbeing, whilst others were debilitated.

With minor methodological adjustments this research (whilst somewhat challenged) continued apace, bringing exciting new dimensions and depth, to the understanding of how community development works to bring about wellbeing outcomes in North Wales communities.

Four community development projects were studied from across North Wales to find what works, for whom, how and in what circumstances.

The research finding was a set of four consistent programme theories and an overarching meta programme theory within which programme theories work synergistically within projects. These findings led to the conclusion that these programme theories may be used to harness and build on both a particularly Welsh sense of ‘Cynefin’, and an understanding of salutogenesis within projects, to enable the communities they work with to develop greater health and wellbeing.

The findings are crucial for the research partner Betsi Cadwaladr University Health Board as they increasingly seek more effective, sustainable ways to involve communities in building their own wellbeing, co-produce effective prevention methods and reduce the need for care services.